JT
Johannie T
1 reviews | Active since Oct 2022
14 Feb 2024, 09:20
GAP Risk Administrators
Ons het jare terug aangesluit by Insuremed wat verander het na GAP Risk, met die rede dat ons gecover is dat al ons in hospitaal dokter kostes wat nie deur die mediese fonds gecover is nie gecover sal word. Ons betaal maandeliks ons debietorder getrou, toe ek nou in eis wil insit vir my man se ekstra dokter kostes vir velkanker wat hulle uitgesny het, kry ek terug voering van hulle - Decline PMB (Prescribed Minimum Benefits) - nou regtig hoekom het ek dan GAP cover as dit nie die GAP uitbetaal ts die wat die dokter vra en die mediesefonds uitbetaal nie. Baie swak. Pasop vir GAP Cover - hulle wil net geld uit jou maak.
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GapRisk Administrators's replyOfficial
17 Oct 2024, 11:32Good day, Johannie T
Thank you for your feedback.
In explanation of your concern, the following:
Prescribed Minimum Benefits (PMBs) are a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. Your policy documents clearly stipulate that GapCover does NOT cover PMB's. Cover is provided by your medical scheme. Please remember that GapCover is a short-term insurance product and not governed by the same rules as that of a medical scheme.
As usual, we advise our clients to please carefully read your policy documents. Also, we offer a pre-assessment service where you can request a pre-assessment of your claim prior to your procedure.
Please feel free to contact us should you require further feedback to your concerns.
Kind regards,
The GapRisk / GapCover Team
Thank you for your feedback.
In explanation of your concern, the following:
Prescribed Minimum Benefits (PMBs) are a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. Your policy documents clearly stipulate that GapCover does NOT cover PMB's. Cover is provided by your medical scheme. Please remember that GapCover is a short-term insurance product and not governed by the same rules as that of a medical scheme.
As usual, we advise our clients to please carefully read your policy documents. Also, we offer a pre-assessment service where you can request a pre-assessment of your claim prior to your procedure.
Please feel free to contact us should you require further feedback to your concerns.
Kind regards,
The GapRisk / GapCover Team
Best regards,
GapRisk Administrators's reply17 Oct 2024, 11:32
Official
Good day, Johannie T
Thank you for your feedback.
In explanation of your concern, the following:
Prescribed Minimum Benefits (PMBs) are a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. Your policy documents clearly stipulate that GapCover does NOT cover PMB's. Cover is provided by your medical scheme. Please remember that GapCover is a short-term insurance product and not governed by the same rules as that of a medical scheme.
As usual, we advise our clients to please carefully read your policy documents. Also, we offer a pre-assessment service where you can request a pre-assessment of your claim prior to your procedure.
Please feel free to contact us should you require further feedback to your concerns.
Kind regards,
The GapRisk / GapCover Team
Thank you for your feedback.
In explanation of your concern, the following:
Prescribed Minimum Benefits (PMBs) are a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. Your policy documents clearly stipulate that GapCover does NOT cover PMB's. Cover is provided by your medical scheme. Please remember that GapCover is a short-term insurance product and not governed by the same rules as that of a medical scheme.
As usual, we advise our clients to please carefully read your policy documents. Also, we offer a pre-assessment service where you can request a pre-assessment of your claim prior to your procedure.
Please feel free to contact us should you require further feedback to your concerns.
Kind regards,
The GapRisk / GapCover Team
Best regards,